Psychopharmacology Tips

A small series of studies by Van Putten (1978) showed that if the first dose of antipsychotic was judged even slightly helpful by a patient, that patient had a good response to the drug over a 4-week trial. On the other hand, if the first dose was unpleasant because of oversedation or early signs of akathisia, the patient did badly during a 4-week trial, even if antiparkinsonian drugs and dosage adjustment were used to their best advantage. It may be that one should give acutely ill patients a different drug every day until one is found that the patient does not dislike. The inverse of this approach is to take good drug histories, whenever possible, and to avoid using drugs that the patient remembers to have been unpleasant (Schatzberg et al., 2003).

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Schatzberg, A.F., Cole, J.O. & DeBattista, C. (2003) Antipsychotic drugs. In: Manual of Clinical Psychopharmacology. (Eds) Schatzberg, A.F., Cole, J.O. & DeBattista, C. pp 159 – 243, Washington, DC: American Psychiatric Press.

Van Putten, T. (1978) Why do schizophrenic patients refuse to take their drugs? Archives of General Psychiatry, 31, 67-72.